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Sitting is bad for your health, also after rehabilitation

Comment by Ines Frederix on behalf of the EACPR Cardiac Rehabilitation Section and Paul Dendale, EACPR Secretary

Objectively-measured sedentary time and its association with markers of cardiometabolic health and fitness among cardiac rehabilitation graduates.
Prince SA, Blanchard CM, Grace SL, Reid RD.
European Journal of Preventive Cardiology 2015; DOI:10.1177/2047487315617101


In a cross-sectional study from Ontario, Canada, the authors investigated the sedentary time of post-cardiac rehabilitation coronary artery disease patients. The associations between sedentary behaviour and measures of cardiometabolic health and fitness were assessed. Accelerometry measurements in 263 post-cardiac rehabilitation patients were used to quantify activity and hence sedentary time.

The results of the study indicated that even among a group of post-cardiac rehabilitation coronary artery disease patients, to whom active living has been promoted, the major part of waking time (7.8 ± 1.4 hours/day) was spent engaged in sedentary behaviours. Sedentary time was weakly correlated with adverse markers of cardiometabolic health such as BMI (r = 0.16, P = .009), waist circumference (r = 0.17, P = .007) and negatively correlated with aerobic capacity (VO2 peak) (r = -0.19, P = .02).

Current European Society of Cardiology (ESC) guidelines prescribe moderate-to-vigorous intensity aerobic exercise training ≥ 3 times a week and for 30 min per session as part of the secondary prevention program for coronary artery disease. Specific recommendations for sedentary time reductions are not included, although sedentary time and physical inactivity are recognised as risk factors. Adding specific sedentary time instructions, may offer a unique opportunity to improve outcomes, specifically gains in cardiorespiratory fitness, one of the key indicators of secondary prevention program success.

Further research is also needed to explore how to motivate post-cardiac rehabilitation patients to sustain a physically active lifestyle with reduced sedentary time in the long-term. In the study described, accelerometers were used to record activity and sedentary time.

However, it would be very interesting to investigate the motivational value of such sensor devices (telemonitoring) in reducing sedentary time.


The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology

Notes to editor

Ines Frederix, MD, Jessa Hospital, Hasselt (Belgium) and Antwerp University Hospital, Antwerp (Belgium)

Paul  Dendale, MD PhD FESC, Jessa Hospital, Hasselt (Belgium) and Hasselt University (Belgium)